目的 探討吉祥安坤丸聯(lián)合屈螺酮炔雌醇片治療肝郁氣滯型月經(jīng)不調(diào)的臨床療效。方法 選取2022年5月—2023年12月在首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院懷柔婦幼保健院診治的肝郁氣滯型月經(jīng)不調(diào)患者122例，根據(jù)不同治療方案隨機分成對照組（61例）和治療組（61例）。對照組口服屈螺酮炔雌醇片，于月經(jīng)來潮第5天開始服用，1片/次，1次/d，連續(xù)服用21 d。治療組患者在對照組基礎(chǔ)上口服吉祥安坤丸，12丸/次，2次/d。兩組患者均進行3個月經(jīng)周期的治療。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候評分，中華生存質(zhì)量量表（ChQOL）評分，性激素雌二醇（E₂）、黃體生成素（LH）和促卵泡生成素（FSH）水平，血清表皮生長因子（EGF）、白細胞介素-1β（IL-1β）和血管內(nèi)皮生長因子（VEGF）水平，以及復(fù)發(fā)率情況。結(jié)果 治療后，對照組和治療組總有效率分別為85.25%和96.72%，兩組比較差異具有統(tǒng)計學(xué)意義（P＜0.05）。治療后，兩組患者中醫(yī)證候評分明顯下降，而ChQOL評分顯著升高（P＜0.05），且治療組各評分較對照組改善的更為顯著（P＜0.05）。治療后，兩組患者E₂、EGF和VEGF水平較治療前明顯升高，而LH、FSH和IL-1β水平明顯降低（P＜0.05），且治療組性激素和血清學(xué)水平較對照組改善更為顯著（P＜0.05）。治療后，對照組6個月內(nèi)的復(fù)發(fā)率為13.11%，明顯高于治療組的1.64%，兩組比較差異具有統(tǒng)計學(xué)意義（P＜0.05）。結(jié)論 吉祥安坤丸聯(lián)合屈螺酮炔雌醇片治療肝郁氣滯型月經(jīng)不調(diào)療效顯著，不僅能夠顯著改善患者臨床癥狀、性激素水平及生存質(zhì)量，同時還能夠降低停藥后復(fù)發(fā)率并促進血清學(xué)指標(biāo)的修復(fù)。

Objective Exploring the therapeutic effect of Jixiang Ankun Pills combined with drospirenone and ethinylestradiol in treatment of menstrual disorders of liver depression and qi stagnation. Methods Patients (122 cases) with menstrual disorders of liver depression and qi stagnation in Huairou Maternal and Child Health Care Hospital, Beijing Obstetrics and Gynecology Hospital of Capital Medical University from May 2022 to December 2023 were divided into control (61 cases) and treatment (61 cases) group based on different treatments. Patients in the control group were po administered with Drospirenone and Ethinylestradiol Tablets from the 5 d of menstruation and continuously for 21 d, 1 tablet/time, once daily. Patients in the treatment group were po administered with Jixiang Ankun Pills, 12 pills/time, twice daily. Patients in two groups were treated for 3 menstrual cycles. After treatment, the clinical evaluations were evaluated, the TCM syndrome score, ChQOL score, levels of hormone E₂, LH and FSH, serum EGF, IL-1β and VEGF levels, and the recurrence rates in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 85.25% and 96.72%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the TCM syndrome scores in two groups were significantly decreased, while the ChQOL scores were significantly increased (P < 0.05), and the scores in the treatment group improved more significantly than those in the control group (P < 0.05). After treatment, the levels of E₂, EGF and VEGF in two groups were significantly higher than before treatment, while the levels of LH, FSH and IL-1β were significantly lower (P < 0.05), and the sexual hormone and serum levels in the treatment group were more significantly improved than those in the control group (P < 0.05). After treatment, the recurrence rate within 6 months in the control group was 13.11%, which was significantly higher than that in the treatment group (1.64%), and the difference between the two groups was statistically significant (P < 0.05). Conclusion The combination of Jixiang Ankun Pill and Quspirone ethinylestradiol tablets has a significant therapeutic effect on liver depression and qi stagnation type menstrual disorders. It can not only significantly improve the clinical symptoms, sex hormone levels, and quality of life, but also reduce the recurrence rate after discontinuation and promote the repair of serological indicators.

R984

首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院懷柔婦幼保健院“東方育苗科研基金”（FYDY-2023-04）